Debate over control of Marin General won't end with Sutter's exit

The end of Sutter Health's management of Marin General Hospital on Wednesday will not resolve a debate that has engulfed the Greenbrae hospital for more than two decades:

Should the hospital be managed by the public, via the ballot box, or a private board?

Kurt Salmon and Associates, a national hospital consulting firm that the district hired in 2007 to create a strategic plan for operating Marin General as a stand-alone hospital, advised that a firewall needed to be created between the elected board and the day-to-day management of the hospital to insulate it from politics. The board has taken that advice, creating a 10-member operating board that will oversee operations. The district board retains the ability to set broader hospital policy.

District board member Larry Bedard credits the consultant's advice with changing the "whole tenor, tone and future" of the hospital.

Some activists who fought hard to dislodge Sutter are optimistic that the new operating board will pay closer attention to patient care and place less emphasis on profits than the existing Marin Hospital Corp. board, which was controlled by Sutter.

District board member Jennifer Rienks said she expects the new operating board to act much the same as would the publicly elected district board.

"There is no other competing interest," Rienks said. "Before, the board of Marin General Hospital had two masters, and that's where the problems arose. A lot of things they were doing weren't good for Marin General but were good for Sutter. They improved Sutter's bottom line."

But other longtime critics of privatization remain skeptical.

"The hospital's not coming back to the district," said former district board member Nancy McCarthy. "It's going to another private corporation that is unaccountable, not subject to the Brown act - they say - not subject to the Public Records Act. The district is just as much of an eunuch now as it was before. Same horse, different rider."

Critics of the new hierarchy note that the new 11-member operating board will nominate its own successors going forward; operating board meetings will be closed to the public; and up to 49 percent of the members of the corporate board may have financial interests in what takes place at Marin General.

The new structure has strong support among Marin physicians who fear the hospital's management otherwise would be subject to political whim.